Healthcare Provider Details

I. General information

NPI: 1326071440
Provider Name (Legal Business Name): JEFFREY DAVID PASLEY D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/09/2006
Last Update Date: 06/03/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3363 HIGHWAY 14
MILLBROOK AL
36054-2424
US

IV. Provider business mailing address

PO BOX 847
MILLBROOK AL
36054-0018
US

V. Phone/Fax

Practice location:
  • Phone: 334-285-8483
  • Fax: 844-654-7165
Mailing address:
  • Phone: 334-285-8483
  • Fax: 844-654-7165

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number2130
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: